The editors of the Pittsburgh Post-Gazette to remonstrate with those who complain that the president lied about the PPACA. So what? It’s still a good policy:
Plans are being canceled because they don’t meet the coverage set out in the Affordable Care Act and leave many people poorly insured. Those Americans who have been canceled can obtain other policies that may be more or less costly but should offer them better coverage than before.
In short, the furor of the supposed great lie is an embarrassment to Mr. Obama, but it obscures the larger and more important truth that the Affordable Care Act remains good policy.
Is it? I’d like to see somebody make the case. What I’ve seen is people defending the idea of the PPACA or its possible future evolution. If you’re defending the PPACA, here’s what you need to defend. The estimate of people without healthcare insurance is between 30 million and 50 million people. According to the CBO, no more than a third of those would be insured under the terms of the PPACA. Consequently, you need to defend the PPACA not on the basis that it insures everybody or that someday everybody might be insured but that leaving between 20 million and 40 million people uninsured is just fine.
You need to defend the PPACA’s expansion of the Medicaid paid by the states beyond their ability to pay. You need to defend the cancellation of hundreds of thousands or millions of people’s insurance not on the basis of their potentially getting better insurance someday but on the basis that they shouldn’t have had even the insurance they had.
I wish them the best of luck. The key point is not merely that the PPACA is bad but that it is inadequate and doesn’t provide the path to future improvement its advocates think it will.
The other day in comments over at OTB a frequent commenter made what I think is the best and most succinct summary of the PPACA I’ve ever read: it was the least disruptive meaningful change the Democrats in Congress thought they could enact. IMO with respect to our healthcare system disruption is directly proportional to meaning.
Here’s my less than fifty word synopsis of our healthcare system. It provides pretty fair healthcare for those who can afford it. It’s mostly subsidized and the subsidies are determined based on political expediency rather than need or merit. Most of the benefits of the subsidies go to providers, stockholders, and the wealthy.
I think that’s a system that needs more disruption rather than less.